Local Board of Health Authority to Address Obesity
Bibliographic Data
We read with interest the article by Pomeranz1 on the authority for state and local health departments to address obesity. We agree that “states and locales are often innovators in creating and implementing public health policy,”1(p1192) and we support that regardless of a health department's size, structure, and authority, they all have a responsibility to protect the public's health and ensure health in all policies.1 However, the statement that the health department has the authority to adopt obesity prevention policies is misleading and an inaccurate depiction of how policies are enacted in today's public health system. Although the terms “health department” and “board of health” are often used synonymously, it is important to clearly differentiate between the 2 because they do operate in different capacities. According to state statutes, the role of local boards of health is to serve as a policymaker for the health jurisdiction, provide an advisory role, complete rulemaking, and operate in a managerial or supervisory role over local health department or other entities.2 This is in contrast to the role of the health department. Local health departments are defined as those that “exist for the common good and are responsible for demonstrating strong leadership in the promotion of physical, behavioral, environmental, social, and economic conditions that improve health and well-being; prevent illness, disease, injury, and premature death; and eliminate health disparities.”3 Therefore, the board of health is often the entity legally responsible for developing and adopting public health policies, whereas the health department and health officer are responsible for instituting programs and services to support those policies. This differentiation is further exemplified by data from our 2011 Local Board of Health National Profile. Primary analysis of the Profile's imbedded random sample shows that local boards of health have the authority to adopt (80.0%), review (93.5%), and revise (82.5%) public health regulations. Additionally, local boards of health have the authority to recommend (88.8%) and establish (81.2%) public health policies.4 It is these local boards of health with rule-making authority, as compared with the health department, that “can use this power to address obesity-related concerns.”1(p1195) Boards of health are the link between the health department and community. This link, together with policies, will drive the citizen engagement needed to improve public health outcomes. It is vital for the public health field to continue engaging and utilizing boards of health, in addition to health departments, to address obesity
Business · Environmental health · Health department · Health promotion · International health · Jurisdiction · Political science · Public health · Public health law · Public relations · Rulemaking · Statute · Global Public Health Policies and Epidemiology · Law · Medicine · Nursing · Obesity, Physical Activity, Diet · Public Health Policies and Education · Health Policy
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